Too ill to work? How the DWP assesses you

At this week’s stall, three separate people approached us asking advice about claiming benefits when they are unfit for work. With this is mind, we thought it would be useful to restate the basic rules of engagement. (Most of this information is on our current leaflet.)

The general advice we give is:

ALWAYS get someone who knows the system to help you to fill in forms.

ALWAYS take someone with you to assessments as a witness and support.

ALWAYS remember that you are not alone. There are people out there to help you.

Under the ‘old’ system, you would apply for Employment and Support Allowance (ESA). If you have recently stopped working, and have enough National Insurance contributions, you are entitled to apply for what they now call ‘New Style’ ESA, which is not means tested.

Otherwise, you will need to apply through Universal Credit. Once you have been on Doctor’s lines on UC for 4 weeks, the DWP should send you a UC35 form for being treated as unfit for work long term. If you don’t receive this, then ask for it. As for ESA, you will have to fill in the forms and attend a Work Capability Assessment. You may still be asked to look for work while waiting for an assessment, but you can argue – with the help of your GP – that there would be substantial risk to your health if you were made to look for work.

Work Capability Assessments are point based, so it is useful to have a copy of what scores what points when filling out the forms. You’ll need to relate these to your condition as much as possible, and not be tempted to downplay your problems. The scoring system – the Work Capability Assessment descriptors – can be found online, but we always advise getting help from a Welfare Advisor if you can. (There’s excellent detailed advice guides on the Benefits and Work website, but you do have to pay a membership fee to access these.)

If you don’t get enough points from the assessment, you can ask for a Mandatory Reconsideration. While this is looked at, you will need to sign on as though you were fit for work. You can ask your doctor for a note to say that the pressures from the Jobcentre are making your health worse and you are not able to work. If the Mandatory Reconsideration doesn’t work, you can appeal. Welfare advisors should help with this. Appeals have a good success rate.

PIP is a separate benefit that is replacing ‘Disability Living Allowance’. It is supposed to cover the extra costs associated with being sick or disabled, and is not means tested. Although the assessment process is similar to ESA, the focus of the questions is a bit different as they are meant to assess your need for help with daily living and with mobility, not whether you can work. You can be eligible for PIP even if you are in work, and if you are getting benefits as unfit for work it is often worth applying for PIP too. Both benefits don’t just cover physical disabilities, but also mental health issues such as severe anxiety and depression.